dental venue - Dental Amalgam Silver Fillings

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Silver Fillings

related: fillings / composite / the amalgam debate

Amalgam is one of the oldest dental materials, predated only by the use of gold. Amalgam is made by mixing approximately equal parts of mercury (43 to 54 percent) and an alloy powder (57 to 46 percent) made up of silver, copper, tin and sometimes smaller amounts of zinc and palladium. There are currently several manufacturers, each producing a material with a slightly different formula.

Approximately 70 percent of all fillings placed annually are replacements of existing fillings. Composites are great for smaller more conservative restorations but lack sufficient strength or durability to be considered adequate for many replacement fillings. Full coverage restorations (crowns or caps), inlays and onlays offer an excellent alternative, however, they can be expensive. For many patients, amalgam offers a relatively inexpensive, durable restorative option.

It’s estimated that more than 1 billion amalgam fillings are placed annually.

Gold and porcelain restorations take longer to make and require two appointments to complete. Composite resins, or white fillings, are esthetically appealing, but require a longer chair time to place. Out of these materials, with the exception of gold, amalgam is far more durable.

Is the Mercury in Dental Amalgam Safe?

Mercury in dental amalgam is not poisonous. When mercury is combined with other materials in dental amalgam, its chemical nature is altered. The amount of mercury released in the mouth under pressure during chewing and grinding is extremely small, far less than what patients are normally exposed to in food, air, and water.

Scientific studies conducted over the last 100 years have not shown dental amalgam to be biologically harmful. Claims of diseases caused by mercury leeched from amalgam simply have not been proven scientifically. It's interesting to note that since dental staff are exposed to mercury more often, one would expect dental personnel to have higher rates of neurological diseases, such as multiple sclerosis. They do not. Amalgam has been in use for over 150 years; it remains one of the safest, durable and least expensive materials available.

Possible Uses

When moisture control is problematic with patients
When cost is an overriding issue
In stress-bearing, non-esthetic areas (a crown, inlay or onlay is usually a better alternative, though)
In cases where there is significant tooth structure loss and cost is an overriding factor (again, crowns are usually a better alternative)
As a foundation for ceramic, metal-ceramic, and all metal restorations

When Amalgam Should Not Be Used

When esthetics is important
Known history of allergy to mercury or other amalgam components
A large restoration is needed and cost is not a factor

Advantages Of Amalgam

1) Single appointment procedure
2) Inexpensive
3) Long life
4) Depending on its constituents, it may inhibit bacterial activity around it

Disadvantages Of Amalgam

1) Completely unaesthetic, cosmetically poor
2) It can stain the surrounding tooth structure to a grayish hue
3) It can stain surrounding soft tissue (cheeks and the gums) a permanent grayish color (amalgam tattoo)
4) Possible tooth fracture. The expansion and contraction of the restoration to the repeated presence of hot and cold liquids can crack or fracture the tooth

What about those patients allergic to mercury?

Approximately 1% of the population is allergic to the mercury present in amalgam restorations. People suspected of having an allergy to mercury should receive tests by qualified physicians, and when necessary, seek appropriate alternatives.

Like shellfish? You’re probably taking in more mercury from the occasional oyster than an amalgam filling.

Should patients have their amalgams removed?

No. To do so, without need, would result in unnecessary expense, and potential injury to teeth.

Other Sources Of Mercury

Mercury is in food, water, and the air we breathe. We're exposed to higher levels of mercury from these sources than from a mouthful of amalgam fillings.

Note: It is important to note that before beginning any course of treatment you should see your dentist. Please note that without the benefit of a full dental examination, including a review of medical history, dental x-rays, and diagnostic aids, no attempt can be made to provide specific diagnosis or recommended courses of treatment. However, we will be happy to update our site to include topics you feel deserve mention. contact us